Trusting the power of “Mana”: Lessons learned in the initial stages of a culturally-based and health equity-focused afterschool program for Pacific Islander high school students

Background: Pacific Islander (PI) adolescents in San Mateo County are exhibiting alarming rates of overweight/obesity and low physical fitness levels. A youth survey revealed additional areas of concern: school drop-out rates, academic achievement, and risk-taking behavior, including gang activity. Focus groups with youth and parents point to a need for academic mentorship, increased cultural pride, and improved problem-solving skills so that youth are able to make informed decisions, set goals, and gain the knowledge and skills to achieve their goals. Methods: A collaboration between San Mateo Union School District, San Mateo County Health System, Taulama for Tongans, City of San Mateo Police Department, Peninsula Conflict Resolution Center, Pacific Islander families, and community-based organizations was developed to implement an after-school program for Pacific Islander youth and their families in one high school in San Mateo County. Expected program outcomes include: increased grade point averages, graduation and college entry rates; decreased youth involvement in risky behavior, increased parent involvement in student lives; increased youth understanding of PI culture; increased skills in goal setting, problem-solving, and developing healthy relationships; and improved parent-child communication. Discussion: Trust is a unifying and basic factor in the development and implementation of a culturally-based, health equity-focused after-school program for PI high school youth, their families, school and project staff, and the broader community. Specific cultural aspects of the intervention present opportunities and challenges for community-based collaboration and program implementation. Initial lessons learned extend beyond PI community to other community-based health equity initiatives.